Ultrasound-guided bilateral parasternal block: A boon for managing pain after sternal fracture/dislocation
Sandeep Diwan, Abhijit NairSaudi Journal of Anaesthesia 2020 14(2):224-227 Sternal fractures are high velocity injuries which is associated with thoracic or lumbar vertebral fractures. Severe pain associated with sternal fractures can lead to impaired ventilation, low partial pressure of arterial oxygen, need of non-invasive or invasive ventilation with an endotracheal tube thereby leading to significant morbidity. In a series of three patients with manubrium sternal dislocation, we administered continuous bilateral parasternal blocks and initiated infusion of local anesthetics for different periods of time in all patients. The high pain scores drastically decreased followed by improved spontaneous ventilation. There was improvement in partial pressure of oxygen in arterial blood gas. None of the patient required a non-invasive or invasive ventilation. The spread of local anesthetic using injection of radio-opaque contrast through bilaterally placed parasternal catheters was followed by a computed tomography scan. This was done after obtaining informed consent from patient and waiver for scan. To the best of our knowledge, this is first report of successful pain management in patients who sustained manubrium – sternal dislocations using bilateral continuous catheters for a prolonged period.
Do you folks have any ideas for my next PIP? I did the back pain one a few years ago and it wasn't too bad. Can I do same one (from AAPMR) again? The other projects don't really pertain to my practice. Any other recommendations?
CONCLUSIONS: The average patient is middle aged (often male) with a history of subacute back pain, sometimes presenting fever and/or neurological damage on diagnosis. Acute phase reactants are frequently raised. Diabetes mellitus, endocarditis and immunosuppressed patients may have the worst chance of a good outcome, therefore these patients should be more carefully managed (always try to obtain an imaging-guided biopsy, correct antibiotic treatment, and a functional and clinical follow-up). PMID: 32446680 [PubMed - as supplied by publisher]
Publication date: Available online 25 May 2020Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral RadiologyAuthor(s): Paul Ryan, Mark Sheehy
Publication date: Available online 24 May 2020Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral RadiologyAuthor(s): Mariana Y Puerta, Ricardo Galhardoni, Manoel Jacobsen Teixeira, Jose Tadeu Tesseroli de Siqueira, Silvia Regina Dowgan Tesseroli de Siqueira
The reason health care systems are taking out massive bank-credit lines is they just suffered through their industry ’s worst financial month ever — and their executives don’t know when the pain will end.
CONCLUSIONS: The findings indicate that the Polish adaptation of the SBQ-R by Osman et al. has good psychometric characteristics and can be considered in both research and clinical practice. PMID: 32447359 [PubMed - as supplied by publisher]
Do you notice that your child or teen is feeling more frustrated and hopeless as the shelter-in-place directive continues? I’m hearing from so many families that things seem to be getting increasingly worse. With thousands of schools switching their grading systems to Pass/Fail, many kids are doing the minimal amount of homework to get by. Some may not be keeping up with hygienic routines. Others have reverted to less mature coping skills, erupting and arguing more than they typically do. What can you do to combat their numbness, hopelessness or regressive behaviors? The first step is acknowledging their very real lo...
BLOATING can be normal, particularly after eating certain foods. But is can also be a sign of serious conditions. If you experience pain and swelling in your tummy and feel full quickly when you eat it could be a sign of cancer.
(Natural News) Conditions that cause chronic pain can be difficult to deal with. Severe and persistent pain not only affects a person’s ability to perform his daily tasks, it also reduces his quality of life. Often, physicians prescribe strong opioids that can block pain receptors in the brain to help patients get pain relief. However,...
OBJECTIVE: The purpose of this study is to summarize the evidence for the association between exposure to a motor vehicle collision (MVC) and future low back pain (LBP). LITERATURE SURVEY: Persistent low back pain (LBP) is a relatively common complaint...